阿托伐他汀钙联合依折麦布用于急性冠状动脉综合征的效果分析

Clinical effect of atorvastatin calcium combined with ezetimibe on acute coronary syndrome

目的分析急性冠状动脉综合征患者联合应用阿托伐他汀钙与依折麦布的效果。方法选取2016年4月至2017年3月首都医科大学宣武医院收治的急性冠状动脉综合征患者136例,按照随机数字表法分为对照组(65例)和联合治疗组(71例)。在规范冠状动脉粥样硬化性心脏病二级预防治疗基础上,对照组接受阿托伐他汀钙20 mg/d治疗,联合治疗组接受阿托伐他汀钙20 mg/d联合依折麦布10 mg/d治疗,均治疗24周。比较2组患者治疗前后血脂水平及高敏C反应蛋白(hs-CRP)、治疗24周内心血管事件及不良反应发生情况。结果治疗24周后,2组患者低密度脂蛋白胆固醇(LDL-C)、总胆固醇及hs-CRP水平均明显低于治疗前,且联合治疗组LDL-C、总胆固醇及hs-CRP水平明显低于对照组[(1.97±0.51)mmol/L比(2.20±0.33)mmol/L、(2.6±0.6)mmol/L比(3.2±0.5)mmol/L、(1.7±1.1)mg/L比(2.2±1.2)mg/L],差异均有统计学意义(均P<0.05)。治疗24周内,联合治疗组再发心绞痛和再发心肌梗死发生率均明显低于对照组[5.6%(4/71)比15.4%(10/65)、1.4%(1/71)比12.3%(8/65)],总不良反应发生率明显低于对照组[5.6%(4/71)比30.8%(20/65)],差异均有统计学意义(均P<0.05)。结论阿托伐他汀钙联合依折麦布用于急性冠状动脉综合征患者,能够改善患者血脂状况,并减少心血管事件及不良反应的发生。

Objective To analyze the clinical effect of atorvastatin calcium combined with ezetimibe on acute coronary syndrome（ACS）. Methods A total of 136 ACS patients admitted from April 2016 to March 2017 in Xuanwu Hospital, Capital Medical University were randomly divided into control group（n＝65） and combined treatment group（n＝71）. The control group was treated with atorvastatin calcium 20 mg/d; the combined treatment group was treated with atorvastatin calcium 20 mg/d and ezetimibe 10 mg/d; both groups were treated for 24 weeks. Blood lipid index and high-sensitivity C-reactive protein（hs-CRP） level, cardiovascular events and adverse reactions were analyzed. Results After 24 weeks of treatment, levels of low-density lipoprotein cholesterol（LDL-C）, total cholesterol and hs-CRP were significantly lower than those before treatment in both groups; levels of LDL-C, total cholesterol and hs-CRP in combined treatment group were significantly lower than those in control group［（1.97±0.51）mmol/L vs （2.20±0.33）mmol/L, （2.6±0.6）mmol/L vs （3.2±0.5）mmol/L, （1.7±1.1）mg/L vs （2.2±1.2）mg/L］（P＜0.05）. Incidence rates of recurrent angina and recurrent myocardial infarction in combined treatment group were significantly lower than those in control group［5.6%（4/71） vs 15.4%（10/65）, 1.4%（1/71） vs 12.3%（8/65）］（P〈0.05）. Incidence of adverse reactions in combined treatment group was significantly lower than that in control group［5.6%（4/71） vs 30.8%（20/65）］（P＜0.05）. Conclusion Atorvastatin calcium combined with ezetimibe treating ACS can effectively regulate blood lipid and reduce cardiovascular events and adverse reactions.